Beijing Institute of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China.
Pain Physician. 2022 Jan;25(1):E87-E94.
Endoscopic rhizotomy (ER) of the medial branch has been recently developed for the treatment of lumbar facet joint pain (LFJP). However, there are no studies comparing the pain-free duration after ER and radiofrequency (RF).
To evaluate the long-term outcomes for pain and physical function in patients who underwent ER versus RF for LFJP and compare their pain-free survival.
Open label, prospective, real-world study that includes patients treated with ER or RF at a single center between November 2017 and February 2020.
The research took place within a single university-based neuro-spine center.
Patients with a positive diagnostic medial branch block (>= 80% pain relief) were treated with ER or RF. Numeric rating scale (NRS), Oswestry Disability Index (ODI), and Global Impression of Change (GIoC) were obtained at the baseline, and at 6 months and 12 months postoperatively. The duration of pain-free time was recorded at every follow-up. The final follow-up was conducted in March 2021.
Of 55 patients with LFJP, 19 underwent ER, and 36 underwent RF. Both ER and RF groups showed significant decreases in NRS and ODI scores at 6 months and 12 months compared with baseline (P < 0.001). ER had significantly better efficacy than RF in NRS, ODI, and GIoC scores at 6 and 12 months (P < 0.05). The pain-free survival curves showed that the median pain-free duration was 20 months and 10 months in ER and RF, respectively.
Patients were not randomized to different groups, which may have led to bias.
Both ER and RF can improve the pain and physical function in patients with LFJP. ER is associated with a longer operative duration and medical expenses; however, it provides more sustained efficacy than RF. The surgical choice should depend on the patients' specific conditions.
内侧支内窥镜下射频消融术（ER）是一种治疗腰椎小关节疼痛（LFJP）的新方法。然而，目前尚无比较 ER 和射频（RF）治疗 LFJP 后无痛持续时间的研究。
评估接受 ER 或 RF 治疗 LFJP 的患者的疼痛和身体功能的长期结果，并比较其无疼痛生存时间。
这是一项单中心、开放标签、前瞻性真实世界研究，纳入 2017 年 11 月至 2020 年 2 月期间接受 ER 或 RF 治疗的患者。
单家大学附属医院神经脊柱中心。
对内侧支阻滞阳性（>80%疼痛缓解）的患者行 ER 或 RF 治疗。患者在基线时、术后 6 个月和 12 个月进行数字评分量表（NRS）、Oswestry 残疾指数（ODI）和总体印象变化（GIoC）评分。记录每次随访时无疼痛时间的持续时间。最终随访于 2021 年 3 月进行。
55 例 LFJP 患者中，19 例行 ER，36 例行 RF。与基线相比，两组患者的 NRS 和 ODI 评分在术后 6 个月和 12 个月时均显著降低（P<0.001）。在术后 6 个月和 12 个月时，ER 组在 NRS、ODI 和 GIoC 评分方面均显著优于 RF 组（P<0.05）。无疼痛生存曲线显示，ER 和 RF 组的中位无疼痛持续时间分别为 20 个月和 10 个月。
患者未随机分配到不同组别，这可能导致了偏倚。
ER 和 RF 均可改善 LFJP 患者的疼痛和身体功能。ER 的手术时间和医疗费用较长，但疗效持续时间长于 RF。手术选择应取决于患者的具体情况。
